CHA News Article

CMS Posts Temporary Instructions for Part B Inpatient Rebilling

The Centers for Medicare & Medicaid Services (CMS) yesterday distributed the attached temporary instructions for providers to use in billing Medicare Part B services following denial of an inpatient admission. Last month CMS issued an administrative ruling and a proposed rule addressing the issue of Part B billing following the denial of a Part A inpatient hospital claim by a Medicare review contractor on the basis that the inpatient admission was determined not reasonable and necessary. The administrative ruling, which became effective immediately, will serve as CMS policy until the proposed rule is finalized. The temporary instructions apply to both Part B types of bills —12x and 13x — and include both electronic and paper submissions. CHA’s summary of the proposed rule is available at www.calhospital.org/sites/main/files/file-attachments/hpa_summary_of_cms_ruling_on_part_b_rebilling.pdf.

While CHA considers the updated policy a win for hospitals, there are potential problems with the proposed rule. To help inform CHA’s comments on the proposed rule, CHA requests that members submit input to Amber Ott, CHA’s vice president, finance, at aott@calhospital.org by April 30. Members should also submit comments online at www.regulations.gov by May 17.

 

 

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